- Staat
- WA
- Alter
- 48,0
- Geschlecht
- F
- Eingang
- 08.02.2022
- Impfdatum
- 04.02.2022
- Beginn
- 05.02.2022
- Tage bis Beginn
- 1,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Anion gap
Basophil count decreased
Blood calcium increased
Blood chloride decreased
Blood creatinine normal
Blood glucose normal
Blood lactic acid
Blood potassium normal
Blood sodium decreased
Blood urea decreased
Carbon dioxide normal
Chills
Condition aggravated
Differential white blood cell count
Electrocardiogram abnormal
Eosinophil count decreased
Full blood count
Glomerular filtration rate
Symptomtext
Severe pain and swelling that continued to behind upper and radiated down right arm. Had low grade fever shaking and chills .Vomited 2/06/2022 for close to two hours straight. Then early am 2/07/2022 had a seizure while in bed witnessed by my significant other. Pain was 7/10 in upper right arm. If I or anyone else accidently touched the area 10/10 pain woke me from a dead sleep. Swelling got worse 2/07/2022 and went to urgent care where I was given two grams of Ceftriaxone through an IV. My heart rate did some spikes to 100-150 to 200 BPM at times while in urgent care. Sent home with oral Ceftriaxone 500mg four times a day for 10 days. Three hours after getting IV antibiotics I broke out into a complete body sweat as if getting out toxins in my body. I could then feel improvement happening at that time.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Seizure
- Hospital-Tage
- -
- Labordaten
- CBC/PLT/DIFF - Details Printer friendly page--New window will open Some test results or notes may be difficult to interpret on your own. We recommend allowing your care team time to contact you regarding follow-up. However if you are unable to wait for them to reach out you may contact your care team if you have any concerns. Details Past Results Graph of Past Results Component Results Component Your Value Standard Range Flag WBC 3.4 K/uL 4.0 - 10.7 K/uL L RBC 4.74 10*6 3.6 - 5.0 10*6 HEMOGLOBIN 11.2 GM/DL 11.4 - 15.5 GM/DL L HEMATOCRIT 35 % 34 - 46 % MCV 74 80 - 98 L MCH 24 27 - 34 L MCHC 32 % 33 - 37 % L RDW 20.3 8.0 - 18.5 H PLATELET COUNT 151 10*3 140 - 450 10*3 Neutrophils, Absolute 2.4 K/uL 2.00 - 7.30 K/uL Lymphocytes, Absolute 0.4 K/uL 1.00 - 3.40 K/uL L MONOCYTES, ABSOLUTE 0.5 K/uL 0.00 - 0.80 K/uL Eosinophils, Absolute 0.0 K/ul 0.0 - 0.5 K/ul Basophils, Absolute 0.0 K/uL 0.0 - 0.2 K/uL COMMENT General Information Collected on 02/07/2022 9:23 AM from BLOOD Resulted on 02/07/2022 9:41 AM Result Status: Final result This test result has been released by an automatic process. BASIC METABOLIC PANEL - Details Printer friendly page--New window will open Some test results or notes may be difficult to interpret on your own. We recommend allowing your care team time to contact you regarding follow-up. However if you are unable to wait for them to reach out you may contact your care team if you have any concerns. Details Past Results Graph of Past Results Component Results Component Your Value Standard Range Flag SODIUM 135 MEQ/L 135 - 145 MEQ/L POTASSIUM 3.5 MEQ/L 3.5 - 5.2 MEQ/L CHLORIDE 96 MEQ/L 99 - 108 MEQ/L L CARBON DIOXIDE 28 MEQ/L 22 - 32 MEQ/L ANION GAP 11 4 - 13 GLUCOSE 96 mg/dL 65 - 140 mg/dL GLUCOSE REFERENCE RANGES: Fasting glucose 65 - 99 mg/dL Random glucose 70 - 126 mg/dL 2 hour post prandial 70 - 140 mg/dL BUN 4 mg/dL 6 - 24 mg/dL L CREATININE 0.51 mg/dL 0.50 - 1.20 mg/dL CALCIUM 8.7 mg/dL 8.6 - 10.3 mg/dL GFR -- above 60 ML/MIN 60 - 100 ML/MIN If you are, no significant chronic kidney disease found. GFR -- above 60 ML/MIN 60 - 100 ML/MIN If you are not, no significant chronic kidney disease found. Patients with a GFR of 60 ml/min or less might be at risk for chronic kidney disease and will need to be tested again to confirm. Some decrease in kidney function generally happens naturally as people age. Certain medicines and other health conditions can also affect your kidneys. Talk to your doctor to find out what steps you can take to protect your kidneys. You can find more information on our website at Collected on 02/07/2022 9:23 AM from BLOOD Resulted on 02/07/2022 9:49 AM Result Status: Final result This test result has been released by an automatic process. LACTATE - Details Printer friendly page--New window will open Some test results or notes may be difficult to interpret on your own. We recommend allowing your care team time to contact you regarding follow-up. However if you are unable to wait for them to reach out you may contact your care team if you have any concerns. Details Past Results Graph of Past Results Component Results Component Your Value Standard Range Flag LACTATE 1.3 mmol/L 0.4 - 2.0 mmol/L General Information Collected on 02/07/2022 9:23 AM from BLOOD Resulted on 02/07/2022 9:48 AM Result Status: Final result This test result has been released by an automatic process. EKG - Details Printer friendly page--New window will open Some test results or notes may be difficult to interpret on your own. We recommend allowing your care team time to contact you regarding follow-up. However if you are unable to wait for them to reach out you may contact your care team if you have any concerns. Details Past Results Graph of Past Results Component Results Component Your Value Standard Range Flag VENTRICULAR RATE 109 BPM BPM ATRIAL RATE 109 BPM BPM P-R INTERVAL 146 ms ms QRS DURATION 84 ms ms Q-T INTERVAL 338 ms ms QTC CALCULATION(BEZET) 455 ms ms P AXIS 61 degrees degrees R AXIS 5 degrees degrees T AXIS 52 degrees degrees DIAGNOSIS LINE Sinus tachycardia Otherwise normal ECG No previous ECGs available Confirmed on 2/8/2022 7:46:49 AM General Information Ordered by PROVIDER, UNSPECIFIED Collected on 02/07/2022 8:54 AM Resulted on 02/08/2022 7:46 AM Result Status: Final result This test result has been released by an automatic process.
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- history of seizures
- Andere Medikamente
- Protonix 40mg Advil
- Allergien
- Sulfa
- Vorherige Impfungen
- -
- Staat
- AZ
- Alter
- 25,0
- Geschlecht
- M
- Eingang
- 23.12.2021
- Impfdatum
- 23.12.2021
- Beginn
- 23.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Blood pressure increased
Contusion
Fall
Joint injury
Loss of consciousness
Neurological examination normal
Skin abrasion
Symptomtext
RN administered two vaccines in the same deltoid muscle per patient preference. The seasonal flu and the Tdap. He was seated in a tall exam chair. RN left the room within seconds of administering the vaccines to make a copy of his covid vaccination card. As RN went to open the door within seconds of leaving him, he had lost consciousness and fell off the table on to the floor. Pt was easily awoken. His pulse was 72 and his O2 sat was 100 %. He spoke within 30 seconds of falling and said "i should have sat in a lower chair, I can't believe that happened so quickly." FNP completed a neuro exam on the patient, WNL. RN checked blood pressure twice, gave him some juice to drink. Pt had an abrasion on his right knee and his left ankle. RN cleansed. he denied need for bandage. he has two quarter size contusions on his forehead. he says he thinks he hit his left knee too. after 20-30 of observation and assessment, sent him home. he has a follow up appointment to recheck his blood pressure on 1/4/2022 with provider.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- Performed a neuro exam. RN checked vitals. BP elevated, which it has been in the past 140/80
- Aktuelle Erkrankungen
- noted lump in testicle, ultrasound showed no acute findings
- Vorgeschichte
- He reports a history of fainting. He reports that he fainted 30 minutes after his first covid vaccine in march of 2021. He fainted many hours after the second covid vaccine in April 2021. He says he has a history of fainting at odd times. He did not expect to faint so quickly this time.
- Andere Medikamente
- None
- Allergien
- No known allergies per chart
- Vorherige Impfungen
- This year, 2021, he fainted after received dose one and two of the moderna vaccines. neither were observed by health care profes
- Staat
- GA
- Alter
- 54,0
- Geschlecht
- F
- Eingang
- 21.01.2022
- Impfdatum
- 14.01.2022
- Beginn
- 15.01.2022
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- SC / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Cellulitis
Chills
Erythema
Fatigue
Feeling hot
Hyperhidrosis
Induration
Injection site induration
Injection site inflammation
Limb mass
Mobility decreased
Pain
Pruritus
Skin tightness
Skin warm
Symptomtext
The NDC Number is: 49281-400-89. The morning after my vaccination I became tired, achy, then sweaty/hot with chills. Had aches, chills, sweats for the next 3 days. At the same time the injection site (top right arm) became inflamed and hard as a rock. I could hardly lift my arm. My arm felt "locked". Then about 5 days after the vaccination, I noticed a large lump/mass on the inside of my bicep. It was red, slightly itchy and very warm. The top of my arm was also still extremely tight and the muscle was hard. Went to Dr. and she said I had cellulitis and prescribed an antibiotic.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Mobility decreased
- Hospital-Tage
- -
- Labordaten
- Depending on improvement, I may need an ultrasound on my right arm to rule out blood clots or other inflammation. This is still TBD.
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- Coronary artery disease
- Andere Medikamente
- 81mg aspirin, 5-10mg Crestor, 100mg Progesterone, low dose estrogen patch
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 38,0
- Geschlecht
- F
- Eingang
- 03.10.2021
- Impfdatum
- 29.09.2021
- Beginn
- 29.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Chills
Fatigue
Injected limb mobility decreased
Injection site erythema
Injection site pain
Injection site swelling
Injection site warmth
Loss of personal independence in daily activities
Pyrexia
Symptomtext
I felt very tired, got a low grade fever, and had chills. My arm was quite sore and I was having trouble moving it. I couldn't raise my arm enough to undress and put on pajamas before bed. The next day the fever and chills were gone but my arm was still very sore and became visibly red and swollen -it was a three inch long rectangle around the injection site that was red and swollen. The injection site itself also feels hotter than the rest of my skin. Now (10/03/21), four days after the injection my arm feels sore/bruised, like what I normally would feel after previous Tdap injections, instead of the reaction I had to this most recent one. The pain, and redness are receding. The swelling on the skin is improving, just more slowly than the pain and redness. Now it feels like that there is swelling in the muscle itself as it is hard and large (in comparison to my non-injected arm).
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injected limb mobility decreased
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- Positive Covid Test 9/12/2021
- Vorgeschichte
- Rhinitis
- Andere Medikamente
- N/A
- Allergien
- Erethromyacin Base, Serconazole, Sulfa, Cephalexin, Amoxicillin, Morhine, Pineapple, Wine, Cats.
- Vorherige Impfungen
- -
- Staat
- GA
- Alter
- 11,0
- Geschlecht
- M
- Eingang
- 04.08.2022
- Impfdatum
- 01.08.2022
- Beginn
- 04.08.2022
- Tage bis Beginn
- 3,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site rash
Symptomtext
Rash around the injection site
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site rash
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- Zyrtec
- Allergien
- Latex Allergy NKDA
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 56,0
- Geschlecht
- F
- Eingang
- 20.12.2021
- Impfdatum
- 15.12.2021
- Beginn
- 16.12.2021
- Tage bis Beginn
- 1,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Diarrhoea
Feeling abnormal
Induration
Oropharyngeal discomfort
Pain
Pain in extremity
Peripheral swelling
Symptomtext
Pt. received vaccine on Wednesday, Thursday she went to work with left upper arm pain. She called our office on Monday to report that Friday the 17th she felt out of it and still has left arm pain, she has some swelling of upper arm and her arm feels hard to touch. She also reports diarrhea, body aches and Friday and Saturday she also had a sensation in her throat that felt weird. This was reported to Dr. immediately who reports he will transmit a Medrol Dosepak.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Diarrhoea
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- migraines, hypothyroidism, vitamin D deficiency
- Andere Medikamente
- levothyroxine, vitamin B12, vitamin D3
- Allergien
- none prior
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 40,0
- Geschlecht
- F
- Eingang
- 13.12.2021
- Impfdatum
- 06.12.2021
- Beginn
- 14.12.2021
- Tage bis Beginn
- 8,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Mass
Pain
Swelling
Symptomtext
Localized swelling with formation of large, well circumscribed mass and associated pain (Adacel)
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pain
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- Mixed connective tissue disease, HTN
- Andere Medikamente
- azathioprine, hydroxychloroquine, estridiol, medroxyprogesterone, amlodipine
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 12,0
- Geschlecht
- F
- Eingang
- 21.10.2021
- Impfdatum
- 06.10.2021
- Beginn
- 06.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: nein
Chest discomfort
Culture throat negative
Dizziness postural
Electrocardiogram
Headache
Nausea
SARS-CoV-2 test negative
Streptococcus test negative
Symptomtext
2 day headache when laying down, x 4 days Dizziness when standing x 4 days Nausea x 1 day Chest tightness
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Dizziness postural
- Hospital-Tage
- -
- Labordaten
- 10/9/21 Rapid strep - Negative, Throat culture, Negative, COVID-19-Negative, EKG ordered, cardiology referral placed
- Aktuelle Erkrankungen
- Concern for lactose intolerance
- Vorgeschichte
- Port wine stain - right anterior calf, Depression
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 23,0
- Geschlecht
- F
- Eingang
- 24.03.2023
- Impfdatum
- 20.03.2023
- Beginn
- 20.03.2023
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Medication error
No adverse event
Symptomtext
inadvertently administered an expired dose of adacel prefilled syringe with no reported adverse event; Initial information received on 21-Mar-2023 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 23 years old female patient who was administered an expired dose of Diphtheria-2/Tetanus/5 Ac Pertussis Vaccine [Adacel] prefilled syringe with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included Meningococcal Vaccine A/C/Y/W Conj (Crm197) (Menveo) for Prophylactic vaccination. On 20-Mar-2023, the patient received 0.5 ml Total (1X) of suspect Diphtheria-2/Tetanus/5 Ac Pertussis Vaccine Suspension for injection (lot number: U6923AA, Expiry date: 21-Jan-2023) (with an unknown strength) via intramuscular route in the left deltoid for immunization. On 20-Mar-2023, the patient was administered an expired dose of Diphtheria-2/Tetanus/5 Ac Pertussis Vaccine prefilled syringe with no reported adverse event (expired product administered) (Latency: same day). It was reported, Caller stated that they administered a dose to a patient, but the dose expired 21Jan2023. Caller is asking for efficacy information or any possible side effects they should watch out for. Action taken: not applicable. Outcome: Unknown This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MD
- Alter
- 14,0
- Geschlecht
- M
- Eingang
- 25.01.2023
- Impfdatum
- 23.01.2023
- Beginn
- 23.01.2023
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
Symptomtext
Patient was seen in office on 01/23/23 and received a tdap that expired on 01/21/23. Patient had no reaction just received a expired vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- AL
- Alter
- 7,0
- Geschlecht
- F
- Eingang
- 01.09.2022
- Impfdatum
- 29.08.2022
- Beginn
- 29.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
No adverse event
Symptomtext
Patient was given a dose of Tdap (Adacel) previously on 8-26-2022. Patient was administered a second dose on 8-29-2022. MA who administered the vaccine reported the incident to the nurse manager immediately after adminstering. The nurse manager notified the physician and the office administrator. No adverse outcomes reported per the physician who followed up with patient.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none known
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- NH
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 24.08.2022
- Impfdatum
- 24.08.2022
- Beginn
- 24.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product preparation issue
Symptomtext
Patient given 0.2mL of undiluted Pfizer pediatric 5-11.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product preparation issue
- Hospital-Tage
- -
- Labordaten
- None at this time.
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- Insomnia, GERD, GAD, depression, nocturnal headaches
- Andere Medikamente
- None
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- IN
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 23.08.2022
- Impfdatum
- 19.08.2022
- Beginn
- 19.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Product preparation issue
Symptomtext
Clinical staff mixed the powder portion of the menveo vaccine with a sterile diluent instead of the liquid portion of the menveo vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product preparation issue
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 19.08.2022
- Impfdatum
- 19.08.2022
- Beginn
- 19.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- 6
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Wrong product administered
Symptomtext
Meningococcal B vaccine given in error. Patient was due for Meningococcal Conjugate.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- UNKNOWN
- Vorgeschichte
- UNKNOWN
- Andere Medikamente
- UNKNOWN
- Allergien
- no
- Vorherige Impfungen
- -
- Staat
- GA
- Alter
- 4,0
- Geschlecht
- M
- Eingang
- 18.08.2022
- Impfdatum
- 11.08.2022
- Beginn
- 11.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Incorrect dose administered
Medication error
No adverse event
Wrong product administered
Symptomtext
patient was inadvertently administered an ADACEL vaccination 11AUG2022 instead of the intended 5th dose of DTaP with no reported adverse event; Initial information received on 11-Aug-2022 regarding an unsolicited valid non-serious case received from other health professional. This case involves a 4 years old male patient who was inadvertently administered an adacel vaccination 11aug2022 instead of the intended 5th dose of dtap with no reported adverse event while receiving vaccines DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL]. The patient's past medical history, medical treatment(s), vaccination(s), concomitant medication and family history were not provided. Concomitant medications included MEASLES VACCINE, MUMPS VACCINE, RUBELLA VACCINE (MMR) for Prophylactic vaccination; and VARICELLA ZOSTER VACCINE (VARICELLA VACCINE) for Prophylactic vaccination. On an unknown date, the patient received suspect DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE produced by unknown manufacturer at an unknown dose (lot number, expiry date: not reported) via unknown route in unknown administration site for immunisation. On 11-Aug-2022, the patient received suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE at a suspect at a dose of 0.5 ml once (lot U6923AA, expiry date: 21-Jan-2023) via intramuscular route in the left thigh for immunisation. On 11-Aug-2022 the patient was inadvertently administered an adacel vaccination instead of the intended 5th dose of dtap with no reported adverse event (wrong product administered) same day latency following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE, (unknown latency) following the administration of DIPHTHERIA and TETANUS AND ACELLULAR PERTUSSIS VACCINE. Action taken: Not applicable. Outcome: Unknown. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Incorrect dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- MMR; VARICELLA VACCINE
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- LA
- Alter
- 13,0
- Geschlecht
- F
- Eingang
- 01.08.2022
- Impfdatum
- 11.07.2022
- Beginn
- 11.07.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Poor quality product administered
Product storage error
Symptomtext
Adacel temperature excursion range from 31.7F to 52.4F for 300 hours due to a refrigerator malfunction with no reported adverse event; Adacel administered after temperature excursion with no reported adverse event; Initial information received on 22-Jul-2022 regarding an unsolicited valid non-serious case received from a physician. This case is linked to case 2022SA302671. This case involves a 13 years old female patient it was reported diphtheria-2/tetanus/5 AC pertussis vaccine [Adacel] had temperature excursion range from 31.7f to 52.4f for 300 hours due to a refrigerator malfunction with no reported adverse event and Adacel administered after temperature excursion with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. It was reported that adacel had temperature excursion range from 31.7f to 52.4f for 300 hours due to a refrigerator malfunction with no reported adverse event (product storage error). On 11-Jul-2022, the patient received a dose of suspect diphtheria-2/tetanus/5 AC pertussis vaccine, suspension for injection (strength: unknown) (lot U6923AA and expiry date: 21-Jan-2023) via intramuscular route in the left deltoid for immunization was administered after temperature excursion with no reported adverse event (poor quality product administered)( latency : same day). Action taken : not applicable. Outcome : Unknown. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Poor quality product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- LA
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 01.08.2022
- Impfdatum
- 19.07.2022
- Beginn
- 19.07.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Poor quality product administered
Product storage error
Symptomtext
Adacel administered post excursion with no reported adverse event; temperature excursion involving Adacel range from 31.7F to 52.4F for 300 hours due to a refrigerator malfunction with no reported adverse event; Initial information received on 22-Jul-2022 regarding an unsolicited valid non-serious case received from other health professional. This case involves a 11 years old female patient to whom adacel administered post excursion with no reported adverse event and temperature excursion involving adacel range from 31.7f to 52.4f for 300 hours due to a refrigerator malfunction with no reported adverse event while receiving vaccine diphtheria-2/tetanus/5 AC pertussis vaccine [Adacel]. The patient's past medical history, medical treatment(s), vaccination(s), concomitant medication and family history were not provided. The condition from 05-Apr-2022 to 15-Jul-2022 was a range from 31.7F to 52.4F for 300 hours due to a refrigerator malfunction (not human error). On 19-Jul-2022, the patient received suspect diphtheria-2/tetanus/5 AC pertussis vaccine at a dose of 0.5 ml (lot U6923AA, expiry date: 31-Jan-2023) via intramuscular route in the left deltoid for immunisation. On an unknown date in 2022 there was temperature excursion involving adacel range from 31.7f to 52.4f for 300 hours due to a refrigerator malfunction with no reported adverse event (product storage error) (unknown latency) following the administration of diphtheria-2/tetanus/5 AC pertussis vaccine. On 19-Jul-2022 adacel administered post excursion with no reported adverse event (poor quality product administered, latency: same day) following the administration of diphtheria-2/tetanus/5 AC pertussis vaccine. Action taken: Not applicable. Outcome: Unknown for the event temperature excursion involving adacel range from 31.7f to 52.4f for 300 hours due to a refrigerator malfunction with no reported adverse event and was Unknown for the event adacel administered post excursion with no reported adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Poor quality product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- LA
- Alter
- -
- Geschlecht
- M
- Eingang
- 01.08.2022
- Impfdatum
- 20.07.2022
- Beginn
- 20.07.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
No adverse event
Poor quality product administered
Product storage error
Symptomtext
Adacel was administered since the excursion with no reported adverse event; Initial information received on 22-Jul-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case is linked to case 2022SA303430(CLUSTER). This case involves a 13 years old male patient and it reported a medication error (there was range from 31.7 to 52.4 Fahrenheit (F) for 300 hours due to a refrigerator malfunction and Adacel was administered since the excursion with no reported adverse event), for the vaccine DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included MENINGOCOCCAL VACCINE A/C/Y/W CONJ (DIP TOX) (MENACTRA). It was reported that there was a condition from 05-Apr-2022 to 15-Jul-2022 and the range was from 31.7 to 52.4 Fahrenheit (F) for 300 hours due to a refrigerator malfunction (not human error) On 20-Jul-2022, the patient received a 0.5 ml dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE, ( lot: U6923AA ; expiry date: 21-Jan-2023) via intramuscular route in the right deltoid for immunization. It was reported that Adacel was administered since the excursion with no reported adverse event (poor quality product administered) (onset date: 20-Jul-2022; latency: same day) Action taken : not applicable. Outcome: unknown This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MS
- Alter
- 12,0
- Geschlecht
- F
- Eingang
- 29.04.2022
- Impfdatum
- 01.02.2022
- Beginn
- 01.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Unevaluable event
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Unevaluable event
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OK
- Alter
- 9,0
- Geschlecht
- M
- Eingang
- 08.03.2022
- Impfdatum
- 08.03.2022
- Beginn
- 08.03.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Inappropriate schedule of product administration
Wrong product administered
Symptomtext
Patient received dose of Tdap in clinic today. Pt's 5th dose of Dtap is counted as invalid. The patients 4th dose was administered on the patients 4th birthday. Per the CDC Recommended Schedule, stating: "Persons age 7?18 years not fully vaccinated* with DTaP: 1 dose Tdap as part of the catch-up series (preferably the first dose); if additional doses are needed, use Td or Tdap"., and per Guidance: "7-10 years of age: No DTaP or Tdap given after 4th birthday" (not stating ON 4th birthday and the patients 5th dose after 4th birthday being invalid), administered Tdap today.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Inappropriate schedule of product administration
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 10.02.2022
- Impfdatum
- 03.02.2022
- Beginn
- 03.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Product storage error
Symptomtext
COVID vaccine given past thaw expiration date.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product storage error
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- allergic rhinitis, allergy to foods
- Andere Medikamente
- cetirizine 10mg tablet daily, hydrocortisone 2.5% ointment BID
- Allergien
- acetaminophen, hydrocodone, cilantro
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 16,0
- Geschlecht
- F
- Eingang
- 02.01.2022
- Impfdatum
- 01.01.2022
- Beginn
- 01.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Interchange of vaccine products
Symptomtext
Patient was administered covid Pfizer vaccine on 1/1/22. Patient was already vaccinated with 2 moderna's elsewhere. Patient was seen by provider and is monitored by nurse for 24 hours. Patient denied any adverse signs or symptoms.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Interchange of vaccine products
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- n/a
- Vorgeschichte
- n/a
- Andere Medikamente
- n/a
- Allergien
- Lactose Intolerant
- Vorherige Impfungen
- -
- Staat
- OR
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 15.12.2021
- Impfdatum
- 15.12.2021
- Beginn
- 15.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Incorrect dose administered
Underdose
Symptomtext
Pt was incorrectly given a Pfizer pediatric dose instead of the adolescent/ adult Pfizer dose. MA did not realized that wrong covid vaccine was given until documentation. MA informed clinic manager and informed of next steps. Pt's guardian was informed that wrong vaccine was given and the per CDC guidelines, pt will need to get second adult Pfizer vaccine after 21 days.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Incorrect dose administered
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- Severe Obesity
- Andere Medikamente
- Albuterol, azithromycin, ergocalciferol, guaifenesin
- Allergien
- Keflex
- Vorherige Impfungen
- -